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    Developments in and experience of kilovoltage X-ray cone beam image-guided radiotherapy.

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    Authors
    Moore, Christopher J
    Amer, Ali M
    Marchant, Thomas E
    Sykes, Jonathan R
    Davies, Julie
    Stratford, Julia
    McCarthy, Claire
    McBain, Catherine A
    Henry, Ann M
    Price, Patricia M
    Williams, Peter C
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    Affiliation
    North Western Medical Physics Department, Christie Hospital, Manchester M20 4BX, UK.
    Issue Date
    2006-09
    
    Metadata
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    Abstract
    This paper offers a realistic review of kilovoltage X-ray cone beam tomography integrated with the treatment machine for image-guided radiotherapy in the light of experience taking a commercial system from prototype development into clinical use. It shows that key practicalities cannot be ignored, in particular the regular characterization of mechanical flex during gantry rotation, the mapping of defects in flat panel image transducers and their response to X-ray exposure. The number of X-ray projections and the doses required for clinically useful cone beam reconstruction at different therapy sites are considered in the context of imaging that is fit for purpose. Three roles for cone beam tomography in radiotherapy are identified: patient setup in three dimensions (3D), where even low dose cone beam tissue detail is superior to megavoltage imaging; disease targeting where, despite wide field scatter and slow scanning, it is possible to generate images that are suitable for tumour delineation even at challenging sites; adaptive treatment planning, where calibrated cone beam images have been shown to provide sufficient target detail to support "plan of the day" selection and have the potential for planning with bulk corrections. With frequent use in mind, the need to limit patient dose during setup, yet maximize much needed image quality in the target zone, is considered. Finally, it is noted that the development of cone beam tomography for radiotherapy is far from complete, with X-ray source, image transducer, reconstruction algorithms and techniques for image profile collection still being researched.
    Citation
    Developments in and experience of kilovoltage X-ray cone beam image-guided radiotherapy. 2006, 79 Spec No 1:S66-78 Br J Radiol
    Journal
    The British Journal of Radiology
    URI
    http://hdl.handle.net/10541/72421
    DOI
    10.1259/bjr/68255935
    PubMed ID
    16980686
    Type
    Article
    Language
    en
    ISSN
    1748-880X
    ae974a485f413a2113503eed53cd6c53
    10.1259/bjr/68255935
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